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Objective:To examine the concordance between bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DXA) in determining body composition of children aged between 3 and 6.Methods:A total of 230 children aged 3-6 from a kindergarten in Jinnan, Tianjin were enrolled in this study from November 16 th to December 8 th, 2017.The soft lean mass (SLM) and the body fat mass (BFM) of the children were measured by using BIA and DXA.The children were divided into several groups by sex, age and body mass index (BMI). The consistency of the body composition results between BIA and DXA in each group was analyzed. Results:The SLM and BFM assessed by BIA were significantly correlated with those measured by DXA ( R2=0.951, 0.947, all P<0.001). The Bland-Altman plots suggested that the SLM measured by BIA was 0.70 kg(95% CI: -1.78-0.38) higher in that by DXA, and the BFM measured by BIA was 1.36 kg (95% CI: 0.19-2.52) lower in that by DXA.A similar trend could be seen in children stratified by age, sex and BMI.The SLM of boys and girls measured by BIA was 0.57 kg (95% CI: -1.63-0.49) and 0.84 kg (95% CI: -1.88-0.20) higher than those by DXA, respectively.The BFM of boys and girls measured by BIA was 1.23 kg (95% CI: 0.11-2.36) and 1.49 kg (95% CI: 0.34-2.64) lower than that by DXA, respectively.The SLM measured by BIA was 0.67 kg (95% CI: -1.74-0.41), 0.76 kg (95% CI: -1.65-0.13), 0.69 kg (95% CI: -1.85-0.47) and 0.67 kg (95% CI: -1.75-0.41) higher than those by DXA in the 3 to 6-year-old groups, respectively.The BFM measured BIA was 1.09 kg (95% CI: -0.12-2.30), 1.44 kg (95% CI: 0.60-2.28), 1.39 kg (95% CI: 0.15-2.64)and 1.43 kg(95% CI: 0.38-2.48)lower than that by DXA in the 3 to 6-year-old groups, respectively.Moreover, the smallest difference of the SLM and BFM were observed between BIA and DXA in the obese child.The SLM deviation between BIA and DXA was estimated within ± 0.39 kg and the BFM deviation was within ± 0.93 kg. Conclusions:There is high consistency between BIA and DXA in the assessment of the SLM and BFM of children aged from 3 to 6.
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【Objective】 To investigate the preoperative anemia and perioperative blood transfusion in patients with duodenal papillary carcinoma who underwent Whipple surgery. 【Methods】 The clinical data of 1 959 cases with duodenal papillary carcinoma, subjected to Whipple surgery, were retrospectively analyzed. 【Results】 The rate of anemia in preoperative patients with duodenal papillary carcinoma was 54.87%(1 075/1 959). The incidence rate of anemia in the three age groups from low to high was 44.92% (≤50 years old, 190/423), 52.82% (51~64 years old, 506/958), and 65.57% (≥65 years old, 379/578) (P<0.05), and the highest rate of anemia occurred in patients aged above 65. There was a significant statistical difference among patients with different body mass index (BMI)(P<0.05). Patients with moderate or severe anemia received more red blood cells than patients with mild anemia during the perioperative period (P<0.05). The average hospitalization time of the blood transfusion patients was 27.25 days, and that of non-transfusion patients was 22.22 days (P<0.05). The amount of blood loss and hospitalization time of patients underwent laparoscopic and robotic surgery were significantly lower than those underwent open surgery patients (P <0.05). There were only 24.09%(186/772) treated with drugs for anemia intervention and the majority of patients (75.91%, 586/772) were treated with blood transfusions to interfere with anemia during hospitalization. 【Conclusion】 There are significant differences in the incidence rate of preoperative anemia among patients with duodenal papillary carcinoma who undergone Whipple surgery. Low BMI, abnormal WBC, and perioperative blood transfusion are high-risk factors for prolonged hospital stay, whereas anemia is not associated with prolonged hospital stay.
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Inhaled antibiotics such as colistin and ciprofloxacin are increasingly used to treat bacterial lung in-fections in cystic fibrosis patients.In this study,we established and validated a new HPLC-MS/MS method that could simultaneously detect drug concentrations of ciprofloxacin,colistin and ivacaftor in rat plasma,human epithelial cell lysate,cell culture medium,and drug transport media.An aliquot of 200 μL drug-containing rat plasma or cell culture medium was treated with 600 μL of extraction solution(acetonitrile containing 0.1％ formic acid and 0.2％ trifluoroacetic acid (TFA)).The addition of 0.2％ TFA helped to break the drug-protein bonds.Moreover,the addition of 0.1％ formic acid to the transport medium and cell lysate samples could significantly improve the response and reproducibility.After vortexing and centrifuging,the sample components were analyzed by HPLC-MS/MS.The multiple re-action monitoring mode was used to detect the following transitions:585.5-101.1 (colistin A),578.5-101.1 (colistin B),393.2-337.2 (ivacaftor),332.2-314.2 (ciprofloxacin),602.3-101.1 (polymyxin 81 as internal standard (IS)) and 595.4-101.1 (polymyxin B2 as IS).The running time of a single sample was only 6 min,making this a time-efficient method.Linear correlations were found for colistin A at 0.029-5.82 μg/mL.colistin B at 0.016-3.14 μg/mL.ivacaftor at 0.05-10.0 μg/mL,and ciprofloxacin at 0.043-8.58 μg/mL.Accuracy,precision,and stability of the method were within the acceptable range.This method would be highly useful for research on cytotoxicity,animal pharmacokinetics,and in vitro drug delivery.
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Objective: To summarize the management principle and clinical suggestions of the osteotomy gap of opening wedge high tibial osteotomy (OWHTO). Methods: The related literature of the osteotomy gap of OWHTO in recent years was reviewed, summarized, and analyzed. Results: Delayed union and non-union of the osteotomy gap are main complications of OWHTO. Tomofix plate, as locking steel plate, has the characteristics of angular stability and can better maintain the stability of the osteotomy gap, promote bone healing, and avoid loss of correction. There are some treatment options for the osteotomy gap site, such as, without bone, autologous bone graft, allogeneic bone graft, bone substitute materials graft, and augment factor graft to enhance bone healing. When the osteotomy gap is less than 10 mm, it achieves a good outcome without bone graft. For the obesity, lateral hinge fracture, large osteotomy gap, or correction angle more than 10°, the bone graft should be considered. In cases whose osteotomy gap is nonunion or delayed union, the autologous bone graft is still the gold standard. When the osteotomy gap repaired with the allogeneic bone graft, it is better to choose fragmented cancellous or wedge-shaped cancellous bone, combining with the locking plate technology, also can achieve better bone union. The bone substitute material of calcium-phosphorus is used in the osteotomy gap, which has the characteristics of excellent bone conduction, good biocompatibility, and resorption, combining with the locking plate technology, which can also achieve better bone union in the osteotomy gap. The augment factors enhance the bone healing of the osteotomy gap of OWHTO is still questionable. The bone union of the osteotomy gap is also related to the size of the osteotomy gap and whether the lateral hinge is broken or not. Conclusion: No matter what type of materials for the osteotomy gap, OWHTO can improve the function and relieve pain for knee osteoarthritis. More randomized controlled trials are needed to provide evidence for clinical decision to determine which treatment option is better for the osteotomy gap of OWHTO.
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Objective@#To investigate the association between blood lipid and calcaneus bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 14 303 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, blood lipid and calcaneus BMD were conducted. Multivariate linear regression was applied to quantify the association between calcaneal BMD as a dependent variable and blood lipid level as an independent variable after adjusting for the potential confounding factors. Furthermore, quantile regression was used to analyze the association between blood lipid level and different percentiles (P25, P50 and P75) of ultrasonic velocity values of bone mineral density, and parallel test was conducted for regression coefficients of different percentiles.@*Results@#A total of 14 303 participants aged (11.4±3.3) years (49.9% boys) were involved in the analysis. The mean age of 14 303 participants was (11.0±3.3) years. 7 142 boys accounted for 49.9%. The mean±SD of calcaneal BMD, total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) were (1 540.9±33.8) m/s, (3.90±0.76), (2.18±0.62), and (1.40±0.32) mmol/L, respectively. The P50 (P25, P75) of triglyceride (TG) was 0.69 (0.49-0.94) mmol/L. After the adjustment of age, height, smoking, drinking, vitamin D and calcium supplementation, dairy intake, physical activity, FMI, and MMI, a significantly inverse association (P<0.05) between TG level and calcaneus BMD was observed in both genders, which the regression coefficients (95%CI) in boys and girls were -0.064 (-0.085, -0.044) and -0.073 (-0.094, -0.053), respectively.@*Conclusion@#The level of BMD was associated with TG in boys and girls. Therefore, it is important to prevent children from hypertriglyceridemia for the bone health promotion.
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Objective@#To understand the association between body fat distribution and calcaneal bone mineral density (BMD) in children and adolescents aged 6-16 years in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method from November 2017 to January 2018. A total of 15 030 students in grade 1 to 4 of primary school, grade 1 of junior and senior middle school were enrolled after excluding subjects who were not able to participate into this study due to trauma or other uncomfortable physical conditions or with missing key values or with diabetes and kidney diseases. Questionnaire survey, body composition and calcaneus bone mineral density were conducted. The relation of fat mass percentage (FMP), trunk to total fat ratio (TrTFR), trunk to limb fat ratio (TrLFR), limb to total fat ratio (LTFR) and viscera to total fat ratio (VTFR) with calcaneus BMD were assessed using the multivariate linear regression models after adjusting for possible confounding effects. The central fat distribution types were divided into 4 groups including type 1: both trunk fat and visceral fat greater than the sex-and age-specific internal P75; type 2: barely trunk fat greater than P75; type 3: barely visceral fat greater than P75; type 4: both trunk fat and visceral fat greater than P75. The central fat distribution types were included into the model in the form of dummy variables to analyze its relationship with calcaneal BMD. The sex-and age-specific z-scores of fat distribution indicators and BMD were calculated.@*Results@#A total of 15 030 participants aged (11.4±3.3) years (50.2% boys) were involved in the analysis. In both genders, after adjusting for age, height, lean mass index, smoking, drinking, physical activity, milk intake, vitamin D and calcium supplementation, FMP, TrTFR, TrLFR and VTFR were negatively correlated with calcaneal BMD (all P value<0.05), while LTFR was positively associated with calcaneal BMD (all P values<0.05). Compared to the central fat distribution type 1, the regression coefficients (95% CI) of type 2, 3 and 4 were -0.253 (-0.418, -0.087), -0.385 (-0.567, -0.204) and -0.428 (-0.487, -0.369) in boys, respectively; the regression coefficients (95% CI) of type 3 and 4 were -0.158 (-0.301, -0.015) and -0.226 (-0.290, -0.163), respectively.@*Conclusion@#Body fat distribution and central fat distribution in children and adolescents were correlated with calcaneus bone mineral density.
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OBJECTIVE@#To explore the effect of small interfering RNA (siRNA)-mediated CEP55 gene silencing on the proliferation of mouse spermatogonia.@*METHODS@#Six patients with azoospermia diagnosed to have maturation arrest (3 cases) or normal spermatogenesis (3 cases) based on testicular biopsy between January 1 and December 31, 2017 in our center were examined for differential proteins in the testicular tissue using isobaric tags for relative and absolute quantitation (iTRAQ), and CEP55 was found to differentially expressed between the two groups of patients. We constructed a CEP55 siRNA for transfection in mouse spermatogonia and examined the inhibitory effects on CEP55 expressions using Western blotting and qPCR. The effect of CEP55 gene silencing on the proliferation of mouse spermatogonia was evaluated with CCK8 assay.@*RESULTS@#In the testicular tissues from the 6 patients with azoospermia, iTRAQ combined with LC/MS/MS analysis identified over two hundred differentially expressed proteins, among which CEP55 showed the most significant differential expression between the patients with maturation arrest and those with normal spermatogenesis. The cell transfection experiment showed that compared with the cells transfected with the vehicle or the negative control sequence, the mouse spermatogonia transfected with CEP55 siRNA showed significantly lowered expressions of CEP55 mRNA and protein ( < 0.05) and significantly decreased proliferation rate as shown by CCK8 assay ( < 0.05).@*CONCLUSIONS@#CEP55 may play a key role in spermatogenesis and may serve as a potential therapeutic target for non-obstructive azoospermia with maturation arrest.
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Animals , Humans , Male , Mice , Azoospermia , Genetics , Cell Cycle Proteins , Genetics , Gene Silencing , Nuclear Proteins , Genetics , Spermatogenesis , Spermatogonia , Tandem Mass Spectrometry , TransfectionABSTRACT
Objective@#To study the efficacy and safety of laparoscopy and open choledochal exploration in the treatment of complicated hepatolithiasis.@*Methods@#From March 2014 to March 2017, 150 cases of complicated hepatolithiasis who were treated in Heji Hospital Affiliated to Changzhi Medical College were selected.The patients were divided into observation group and control group according to random number table, with 75 cases in each group.The control group was treated with conventional open abdominal common bile duct exploration, and the observation group was treated by laparoscopic choledochal exploration.The levels of surgical indicators, the incidence of complications, the recurrence rate, the bilirubin level before operation and 1 month after operation, and the quality of life before operation and 6 months after operation were compared between the two groups.@*Results@#The operative time, intraoperative blood loss, gastrointestinal recovery time and hospitalization time in the observation group were (154.23±20.47)min, (59.12±8.92)mL, (19.65±3.48)h, (11.48±2.48)d, respectively, which were significantly lower than those in the control group [(217.59±30.59)min, (87.24±10.17)mL, (27.87±6.12)h, (16.51±4.28)d] (t=14.908, 18.002, 10.112, 8.806, all P<0.05). The levels of total bilirubin, direct bilirubin and indirect bilirubin in the observation group at 1 month after operation were (14.38±3.69)μmol/L, (3.39±1.17)μmol/L, (11.45±3.02)μmol/L, which were significantly lower than those in the control group [(28.43±4.31)μmol/L, (6.31±2.08)μmol/L, (21.05±4.87)μmol/L] (t=21.445, 10.596, 14.508, all P<0.05). The incidence rate of complications and recurrence rate of the observation group at 6 months after operation were 2.67% and 0.00%, respectively, which were lower than 14.67% and 10.67% of the control group (χ2=6.822, 8.451, all P<0.05). The scores of social activities, energy, physical activity and sleep mood in the observation group at 6 months after operation were (4.72±0.85)points, (13.25±1.21)points, (3.81±0.51)points, (6.52±2.44)points, respectively, which were higher than those in the control group [(2.65±0.61)points, (8.09±0.68)points, (1.95±0.52)points, (3.98±2.38)points] (t=10.513, 11.605, 12.604, 6.454, all P<0.05).@*Conclusion@#Laparoscopic choledochal exploration is effective in the treatment of complicated hepatolithiasis, and it can improve the level of bilirubin and improve the quality of life, the safety is good.
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Objective To study the efficacy and safety of laparoscopy and open choledochal exploration in the treatment of complicated hepatolithiasis.Methods From March 2014 to March 2017,150 cases of complicated hepatolithiasis who were treated in Heji Hospital Affiliated to Changzhi Medical College were selected .The patients were divided into observation group and control group according to random number table ,with 75 cases in each group. The control group was treated with conventional open abdominal common bile duct exploration ,and the observation group was treated by laparoscopic choledochal exploration.The levels of surgical indicators,the incidence of complications, the recurrence rate,the bilirubin level before operation and 1 month after operation,and the quality of life before operation and 6 months after operation were compared between the two groups.Results The operative time,intraoperative blood loss,gastrointestinal recovery time and hospitalization time in the observation group were (154.23 ±20.47) min, (59.12 ±8.92)mL,(19.65 ±3.48)h,(11.48 ±2.48) d,respectively,which were significantly lower than those in the control group [(217.59 ±30.59) min,(87.24 ±10.17) mL,(27.87 ±6.12) h,(16.51 ±4.28) d] ( t ＝14.908,18.002,10.112,8.806,all P＜0.05).The levels of total bilirubin,direct bilirubin and indirect bilirubin in the observation group at 1 month after operation were (14.38 ±3.69) μmol／L,(3.39 ±1.17) μmol／L,(11.45 ± 3.02)μmol／L,which were significantly lower than those in the control group [(28.43 ±4.31) μmol／L,(6.31 ± 2.08)μmol／L,(21.05 ±4.87) μmol／L] ( t ＝21.445,10.596,14.508, all P ＜0.05).The incidence rate of complications and recurrence rate of the observation group at 6 months after operation were 2.67% and 0.00%, respectively,which were lower than 14.67%and 10.67%of the control group (χ2 ＝6.822,8.451,all P＜0.05). The scores of social activities ,energy,physical activity and sleep mood in the observation group at 6 months after operation were (4.72 ±0.85)points,(13.25 ±1.21)points,(3.81 ±0.51)points,(6.52 ±2.44)points,respectively, which were higher than those in the control group [( 2.65 ±0.61 ) points, ( 8.09 ±0.68) points, ( 1.95 ± 0.52)points,(3.98 ±2.38)points] (t＝10.513,11.605,12.604,6.454,all P＜0.05).Conclusion Laparoscopic choledochal exploration is effective in the treatment of complicated hepatolithiasis , and it can improve the level of bilirubin and improve the quality of life,the safety is good.
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Objective@#To investigate the influence of change in blood pressure status from childhood to adulthood on renal damage.@*Methods@#Data were obtained from Beijing Blood Pressure Cohort initiated from 1987. 3 198 children and adolescents aged 6-18 years from 6 primary and 6 middle schools in Chaoyang, Xicheng and Haidian Districts of Beijing were enrolled at baseline by using a cluster random sampling method, and 1 222 participants were followed up during 2010-2012. The measurements included weight, height, and blood pressure at baseline and microalbumin, serum creatinine, cystatin C and blood pressure at follow-up. Based on blood pressure status in childhood and adulthood, the participants were divided into four groups: participants with normal blood pressure in both childhood and adulthood, participants with elevated blood pressure in childhood but normal blood pressure in adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood, and participants with elevated blood pressure in both childhood and adulthood. Multivariate linear regression model was used to investigate the association of change in blood pressure from childhood to adulthood on renal dysfunction.@*Results@#The prevalence of elevated blood pressure in childhood and adulthood was 17.9% and 39.9%, respectively. The P50 (P25-P75) of microalbumin was 5.7(3.0-12.0) mg/L, and the concentration of eGFR and cystatin C were (118.0±19.8)% and (0.734±0.184)mg/L, respectively. With adjustment for sex, baseline age and follow-up years, compared with participants with persistently normal blood pressure from childhood to adulthood, participants with normal blood pressure in childhood but elevated blood pressure in adulthood had significantly higher levels of microalbumin (β=0.502, 95%CI: 0.320-0.684) and cystatin C (β=0.049, 95%CI: 0.025-0.073). After adjustment for sex, baseline age, follow-up duration, and adult BMI, smoking and drinking, participants with normal blood pressure in childhood and elevated blood pressure in adulthood had higher levels of adult urine microalbumin (β=0.322, 95%CI: 0.128-0.516) and cystatin C (β=0.032, 95%CI:0.007-0.057).@*Conclusion@#An increase in blood pressure during childhood and adulthood has an adverse impact on renal functional damage in adulthood. These findings underscore the importance of maintaining normal blood pressure during life course to prevent the development of chronic kidney disease.
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Objective@#To describe the baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program(SCVBH) in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method. 15 391 students in grade 1 to 4 from primary schools, grade 1 from junior and senior high schools were enrolled in the investigation with an exclusion of students who were not able to participate due to trauma or other uncomfortable physical conditions. The baseline survey including a questionnaire survey, physical examination and blood biochemical test was conducted from September 2017 to January 2018. Obesity, blood pressure, fasting blood glucose, lipid, bone density and grip were evaluated.@*Results@#The prevalence of obesity, hypertension, hyperglycemia (impaired fasting glucose and diabetes), dyslipidemia, lower bone density were 22.3%(3 394), 14.8%(2 248), 10.4%(1 490), 20.3%(2 919) and 2.1%(316) in total respectively, and 27.2%(2 081), 16.3%(1 244), 12.8%(922), 22.2%(1 595) and 1.2%(94) for boys, 17.3%(1 313), 13.3% (1 004), 7.9%(568), 18.4%(1 324) and 2.9%(229) for girls. Boys had higher prevalence of obesity, hypertension, hyperglycemia, and dyslipidemia and lower prevalence of low bone density than girls (all P values <0.05) The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05).The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05), the mean of fat mass percentage, total cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol of boys were significantly lower than those of girls (all P values <0.05).@*Conclusion@#The prevalence of risk factors of chronic cardiovascular disease was high and the low bone density was appearing in children and adolescents in this study. The promotion of cardiovascular and bone health should be implemented in children and adolescents.
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Objective To examine the value of child and adolescent Korotkoff phase Ⅳ(K4)and Korotkoff phaseⅤ(K5)diastolic blood pressures for predicting subclinical cardiovascular disease(CVD)in adulthood.Methods The data was obtained from the Beijing Children Blood Pressure Study.A total of 3 198(1 700 males,53.2%)healthy children aged 6-18 years from 6 districts in Beijing in 1987 were selected.The physical examination process included measuring height,weight,and blood pressure.From a follow-up survey in 2010-2012,1 252 subjects were analyzed by the same measurements (height,weight and blood pressure)and also by using subclinical markers for vascular damage,including carotid intima-media thickness (cIMT)and carotid-femoral pulse wave velocity (cfPWV).Childhood hypertension at baseline and adulthood hypertension were diagnosed according to the China Guideline for Hypertension Prevention and Control issued in 2010.High cfPWV and high cIMT were defined in adults as having higher than age and gender-specific 75th percentile of cfPWV and cIMT.Pearson correlation coefficients were calculated to describe the association of K4 and K5 in childhood with systolic blood pressure(SBP),diastolic blood pressure(DBP),cfPWV, and cIMT in adulthood.Logistic regression was used to analyze the values of K4 and K5 to predict subclinical CVD in adulthood.Results The baseline mean value of K4 DBP was (66.4 ± 9.1)mmHg (1 mmHg＝0.133 kPa)and K5 DBP was (54.1 ± 11.1)mmHg.The prevalence rates of high-normal blood pressure were 9.4% with DBP measured by using K4,and 6.9% with DBP measured by using K5,respectively. The prevalence rates of hypertension were 11. 3% with DBP measured by using K4,and 8.4%with DBP measured by using K5.After adjustment for age and follow-up age,Pearson correlation analyses showed K4 DBP and K5 DBP in childhood were all significantly associated with adult SBP,DBP,cIMT,cfPWV in males and in females (all P＜0.05).K4 in childhood was better correlated with SBP,DBP,cIMT and cfPWV in adulthood than K5.With multi-factor logistic regression analysis,K4 was better than K5 in predicting CVD in adulthood after controlling gender and age.Further K4 was more effective in predicting cfPWV than cIMT.Conclusions There was a significant difference between K4 and K5 in Chinese children and adolescents. K4 in childhood was better correlated with CVD in adults than K5,and K4 is superior to K5 when using auscultator technique to measure DBP.
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Extremity compartment syndrome can cause neuromuscular ischemia and deposition of metabolites in the compartment,leading to irreversible lesions which harm limb functions in the end.It is a great challenge for surgeons to make a timely and accurate diagnosis of the syndrome in adults and children.The key is evaluation of the clinical symptoms and intracompartmental pressure.In this paper we summarize the epidemiology,etiology,pathophysiology,and current diagnosis and treatment of acute extremity compartment syndrome of the upper and lower extremities in adults and children.
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Objective To investigate the effects of 5-hydroxy-1-methylhydantoin (HMH) on kidney injury induced by paraquat (PQ). Methods Fifteen SPF healthy Kunming mice were randomly divided into normal saline (NS) control group, PQ poisoning model group and HMH intervention group, with 5 mice in each group. PQ poisoning model was challenged by one-time gavage of 30 mg/kg PQ solution. The NS group received the same amount of NS by gavage. The HMH group was given 100 mg/kg of HMH immediately after the model was made and continued to be gavaged. Mice in each group were sacrificed 1 day after HMH gavage and heart blood and renal tissue were harvested for examination. The morphological changes of renal tissue were observed under light microscope by hematoxylin-eosin (HE) staining. The content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) in renal tissue were detected according to the instructions of the kit. The expression of heme oxygenase-1 (HO-1) and interleukin-1β (IL-1β) in renal tissues were detected by Western Blot. The serum metabolites were detected by gas chromatography time-of-flight mass spectrometry (GC-TOF-MS), the overall distribution of each sample was observed by principal component analysis (PCA), the accuracy of the model was evaluated by multidimensional analysis orthogonal partial least squares-discriminant analysis (OPLS-DA), and the difference metabolites were screened by variable importance in the projection (VIP) value > 1. Results Light microscopic observation showed that: glomerular structure in NS group was clear, there was no hyperemia and inflammatory cell infiltration in renal interstitium and blood vessels. In PQ group, some glomeruli atrophy and necrosis, capillary congestion in glomeruli, infiltration of inflammatory cells around glomeruli, swelling of renal tubular epithelial cells, slight stenosis of lumen, and occasional necrosis and exfoliation of epithelial cells occurred. The degree of kidney injury in HMH group was significantly less than that in PQ group. Compared with the NS group, the content of MDA in the PQ group was significantly increased (nmol/g: 6.70±0.84 vs. 2.70±0.43, P < 0.01) and the activity of SOD was significantly decreased (kU/L: 33.30±4.66 vs. 50.20±3.23, P < 0.05), the protein expression of HO-1 and IL-1β were significantly increased (HO-1/β-actin: 1.11±0.12 vs. 0.61±0.13, IL-1β/β-actin: 0.93±0.13 vs. 0.32±0.06, both P < 0.05). Compared with the PQ group, the content of MDA in the HMH group was significantly decreased (nmol/g: 5.10±0.93 vs. 6.70±0.84, P < 0.05) and the activity of SOD was significantly increased (kU/L:61.00±9.02 vs. 33.30±4.66, P < 0.05), the protein expression of HO-1 was significantly decreased (HO-1/β-actin:0.77±0.07 vs. 1.11±0.12, P < 0.05), however, there was no significant difference in the protein expression of IL-1β (IL-1β/β-actin: 0.87±0.13 vs. 0.93±0.13, P > 0.05). Metabolite detection results showed that: compared with NS group, the levels of creatinine, glycine, succinic acid, fumaric acid and citric acid were significantly increased in the PQ group (VIP value was 1.50, 1.58, 1.64, 1.74 and 1.95 respectively, all P < 0.05), while the levels of palmitic acid, α-tocopherol and 6-phosphogluconic acid were significantly decreased (VIP value was 1.10, 1.55 and 1.56 respectively, all P < 0.05). Compared with the PQ group, the levels of creatinine and citric acid were significantly decreased in the HMH group (VIP value was 1.50 and 1.86, both P < 0.05), while trans-4-hydroxy-proline, D-glyceric acid, 2, 6-fructose phosphate, 6-phosphate gluconic acid and aminomalonic acid were significantly increased (VIP value was 1.36, 1.55, 1.63, 1.68 and 1.76 respectively, all P < 0.05). Conclusions HMH protects kidney injury caused by PQ poisoning by correcting tricarboxylic acids cycle disturbance, lipid peroxidation and energy metabolism disturbance, and its mechanism is related to the regulation of HO-1 protein expression through Nrf2 pathway.
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BACKGROUND: Ischemic postconditioning protects the myocardium from ischemia/recursion injury via maintaining 3-minute acidosis initially. But its effect on the skeletal muscle remains unclear. OBJECTIVE: To dynamically measure the pH values in rat skeletal muscle after ischemia, and then to simulate acidic perfusate infusion to investigate the effect of ischemic postconditioning on ischemia/reperfusion injury. METHODS: Based on the ischemia/reperfusion injury model and ischemic postconditioning protocol in previous study, dynamic measurement of pH values in rat skeletal muscle was conducted using pH instrument at the global ischemia, ischemic postconditioning (30/30 seconds) and reperfusion period, and then the acidic perfusate equivalent to pH in ischemic postconditioning period was prepared with lactic acid and normal saline. Twenty-five healthy adult male Sprague-Dawley rats were randomly divided into sham, ischemia/reperfusion, ischemic postconditioning, lactic acid, and normal saline groups (n=5 per group). Blood samples were collected to detect lactate dehydrogenase level. The samples from gastrocnemius were harvested to calculate the wet/dry ratio, level of myeloperoxidase, and infarct size through triphenyltetrazolium chloride staining. The samples from the right tibialis anterior muscle were taken to detect the expression level of Erk1/2 in the MAPK signaling pathway by western blot assay. RESULTS AND CONCLUSION: A prolonged acidic platform was detected in the early reperfusion during ischemic postconditioning, on which the pH value was 6.81±0.133, and the duration was 2 minutes and 40 seconds. The levels of lactate dehydrogenase and myeloperoxidase as well as the wet/dry ratio in the ischemic postconditioning and lactic acid groups were significantly lower than those in the ischemia/reperfusion group (P < 0.05). Western blot assay results showed that the expression level of p-Erk in the ischemic postconditioning, lactic acid and normal saline groups was significantly higher than that in the ischemia/reperfusion group (P < 0.05). Triphenyltetrazolium chloride staining results showed that compared with the ischemia/reperfusion group, the infarct area was significantly reduced in the postconditioning and lactic acid groups (P < 0.05). These findings suggest the existence of a short acidosis during ischemic postconditioning in the early reperfusion, and acidic perfusate can simulate the ischemic postconditioning and effectively attenuate ischemia/reperfusion injury in the rat skeletal muscle via activating Erk1/2 in RISK signaling pathway.
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Objective To establish a HPLC-MS method for determination of aconitum alkaloids in biological samples. Methods The aconitum alkaloids were extracted from the whole blood by using acetonitrile-methanol (5:1 v/v) and then analyzed using HPLC-MS in multiple reaction monitoring (MRM) mode with positive ionization. The analytical column was Agilent Zorbax SB C18 (2.1mm×50mm, 1.8μm)and the mobile phase were water containing 0. 1 % formic acid : acetonitrile (60 : 40 v/v) in isocratic elution. Results The retention time of detection of the aconitine, hypaconitine and mesaconitine were 0.73 min, 0.77 min and 0.63 min, and the precursor product ion combinations of m/z 646.4 → 586.4, 616.1 → 556.5 and 632.4 → 572.1 were used for quantitative analysis, respectively. Calibration curve was linear within the range of 0.1-250 ng/mL with the LOD was 0.1ng/mL, and the coefficient of variation (CV) less than 5.42 % (n=6). The extraction recoveries of aconitine in blood were more than 90 %.Conclusion The results demonstrated that the present method was reliable and robust for natural drugs.
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<p><b>OBJECTIVE</b>To investigate the correlation between obesity in children and diabetes in adults from a cohort study, and further more to explore the necessity of preventing diabetes by controlling obesity in children.</p><p><b>METHODS</b>In 1987, 3 198 children and adolescents aged 6-18 were recruited from 6 elementary schools and 6 high schools located in 3 districts (Chaoyang, Haidian, and Xicheng) of Beijing using stratified cluster sampling design. The physical examination process included physical development test, blood pressure measurement, and questionnaire investigation. All children were invited to participate in the study, except for those who had history of congenital heart disease, chronic kidney disease, and limb disability. A total of 1,225 adults were enrolled in a prospective follow-up study from March 2010 to July 2012, anthropometric measures and blood sample were obtained. The obesity was defined by the following criteria: for children aged 6, the age-and the gender-specific 95th percentile of BMI from the US Centre for Disease Control and Prevention Growth charts 2000 as the baseline; for children age 7-18, recommendation from Working Group on Obesity in China (WGOC) as the standard; for adults, BMI≥28 kg/m(2) as the diagnosis standard. Diabetes was defined based on fasting plasma glucose(FPG) ≥7.0 mmol/L or 2 hours postprandial blood glucose (2 h PG) ≥11.1 mmol/L or glycosylated hemoglobin (HbA1c) ≥6.5% or current using blood glucose-lowering agents or current using insulin. Logistic regression was used to analyze the association obesity in children with diabetes in adults.</p><p><b>RESULTS</b>The prevalence of diabetes diagnosed by FPG and 2 h PG in adults who were obese children (16.2%, 18/111) was higher than those who were non-obese children (5.6%, 62/1,114)(χ(2)=18.76, P<0.001). The prevalence of diabetes diagnosed by HbA1c in adults who were obese children(18.1%,20/111) was higher than those who were non-obese children (6.9%, 77/1,114) (χ(2)=16.66, P<0.001). With multi-factor logistic regression analysis, we found that after controlling follow-up age, genders and lifestyle (smoking, alcohol consuming, dietary, and sleeping), in comparison with those non-obese from childhood to adulthood, those obese only in childhood or only in adulthood did not predict any risk of diabetes diagnosed by blood glucose in adults (OR(95%CI) were 1.90 (0.86-4.19), 1.71(0.50-5.79), respectively). Those obese both in childhood and in adulthood increased the risk of diabetes diagnosed by blood glucose in adults (OR(95%CI) was 4.50(2.22-9.14)). With multi-factor logistic regression analysis, we found that after controlling age, sex and lifestyle (smoking, alcohol consuming, dietary, and sleeping) in comparison with those non-obese from childhood to adulthood, those obese only in childhood or only in adulthood did not increase the risk of diabetes diagnosed by HbA1c in adults (OR(95%CI) were 1.42(0.71-2.86), 3.13(0.83-11.75), respectively). Those obese both in childhood and in adulthood increased the risk of diabetes diagnosed by HbA1c in adults (OR(95%CI) was 5.93(3.06- 11.49)).</p><p><b>CONCLUSION</b>Obesity in children even sustained to adulthood was a risk factor for diabetes in adulthood. It is necessary to control obesity in children to prevent diabetes in adults.</p>
Subject(s)
Adolescent , Adult , Child , Humans , Beijing , Blood Glucose , Diabetes Mellitus , Epidemiology , Diet , Follow-Up Studies , Insulin , Therapeutic Uses , Life Style , Pediatric Obesity , Epidemiology , Prevalence , Prospective Studies , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To observe the effect of childhood excessive adiposity on long-term risk of adult carotid atherosclerosis and arterial stiffness.</p><p><b>METHODS</b>At baseline, in 1987, by using stratified cluster sampling design, 3 198 healthy children aged 6-18 were recruited from six primary schools and six middle schools from three districts (Chaoyang, Xicheng, and Haidian) in Beijing, with blood pressure, weight, height and left scapular skinfold thickness (LSSF) measured. From April 2010 to July 2012, 1 225 subjects were followed from childhood to adulthood. Questionnaire, biochemistry parameters, carotid-femoral pulse wave velocity (cfPWV), and carotid intima media thickness (cIMT) were measured at follow-up. Based on weight statuses in childhood and adulthood, subjects were classified into four groups (persistent non-overweight from childhood to adulthood, overweight in childhood but non-overweight in adulthood, non-overweight in childhood but overweight in adulthood, persistent overweight from childhood to adulthood). Multiple logistic regression model was used to analyze the association between weight statuses changing from childhood to adulthood and adult high cfPWV and high cIMT.</p><p><b>RESULTS</b>The prevalence of overweight (including obesity) at adulthood was 52.2% (639). Males had higher prevalence of smoking (62.5%(422/675) vs 29.4%(160/550), χ(2)=133.21, P<0.001), drinking (52.1%(353/675) vs 26.1%(140/550), χ(2)=87.13, P<0.001), overweight (including obesity) (69.3% (468/675) vs 31.1% (171/550), χ(2)=182.18, P< 0.001) than females. With adjusting for gender, age, and length of follow-up, the risk of high cfPWV and high cIMT increased by 26% and 58% for 1 units increase in BMI, and by 30% and 36% for 1 units increase in LSSF. Compared to subjects with persistent non-overweight from childhood to adulthood, subjects with overweight in childhood but non-overweight in adulthood had similar risks of high cfPWV (OR=1.59, 95%CI: 0.77-3.30)and high cIMT (OR=1.47, 95%CI:0.65-3.31). The risks of high cfPWV and high cIMT increased among subjects with non-overweight in childhood but overweight in adulthood (OR=1.92, 95%CI:1.37-2.68; OR=3.69, 95% CI:2.61- 5.23) and among subjects with persistent overweight from childhood to adulthood (OR=2.53, 95%CI:1.70-3.76; OR=5.37, 95%CI:3.62-7.97).</p><p><b>CONCLUSIONS</b>We concluded that a overweight children changed to a healthy weight adult, the risks of adult subclinical atherosclerosis and arterial stiffness would not be increased.</p>
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Adiposity , Atherosclerosis , Epidemiology , Beijing , Blood Pressure , Body Mass Index , Carotid Artery Diseases , Epidemiology , Carotid Intima-Media Thickness , Overweight , Epidemiology , Pediatric Obesity , Epidemiology , Pulse Wave Analysis , Risk Factors , Vascular StiffnessABSTRACT
<p><b>OBJECTIVE</b>To examine the prevalence of obesity phenotypes and cardiometablic disorders (CDs) among children aged 6- 17 in Beijing from 2004 to 2013.</p><p><b>METHODS</b>Data were obtained from two cross-section surveys, which were conducted in 2004 and 2013. In 2004, by using stratified cluster sampling design, 20 primary or middle schools were selected from 7 districts (Xicheng, Dongcheng, Chaoyang, Haidian, Daxing, Pinggu, and Yanqing) in Beijing, and 20 554 school children aged 6-17 were recruited, with weight, height, waist circumference and blood pressure measured. Fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were measured in 962 subjects from one school. In 2013, by using the same sampling design, 7 211 students from two districts (Haidian and Dongcheng) were surveyed with weight, height, waist circumference and blood pressure measured, and fasting plasma glucose and lipid profile (TC, TG, HDL-C, LDL-C) were measured for 1 344 subjects in the same school measured in 2004. Student's-t test was used to analyze the difference in body mass index(BMI), WC, and waist to height ratio (WHtR) among children between 2004 and 2010. Chi-square test was used to analyze the difference of hypertension, impaired fasting glucose(IFG), dyslipidemia, and metabolic disorders clustering between 2004 and 2010, and among different types of obesity; logistic regression model was used to analyze the association between three types of obesity and risks of cardiovascular metabolic disorders.</p><p><b>RESULTS</b>In boys, BMI ((20.3 ± 4.4) vs (19.4 ± 4.2) kg/m(2), t=11.18, P<0.001), WC ((70.6 ± 12.8) vs (66.7 ± 11.8) cm, t=17.20, P<0.001) and WHtR (0.451 ± 0.064 vs 0.437 ± 0.059, t=11.64, P<0.001) were significantly higher in 2013 than those in 2004. Similarly in girls, BMI ((18.9 ± 3.6) vs (18.7 ± 3.7) kg/m(2), t=12.21, P<0.001), WC ((64.5 ± 9.6) vs (63.0 ± 9.3) cm, t=8.15, P<0.001) and WHtR (0.430 ± 0.047 vs 0.423 ± 0.047, t=14.13, P<0.001) were also significantly higher in 2013 than those in 2004. The prevalence of combined obesity rose from 8.27% (1 697/20 526) in 2004 to 10.74% (774/7 209) in 2013, and central obesity from 3.08% (632/20 526) to 4.44% (320/7 209). The prevalence of hypertension (10.78%(313/1 344) vs 4.29% (42/962), χ(2)=36.76, P<0.001), IFG(49.54%(664/1 344) vs 6.45%(63/962), χ(2)=506.61, P<0.001), high TC(11.53%(155/1 344) vs 5.03%(49/962), χ(2)=28.31, P< 0.001), high TG(7.51%(101/1 344) vs 3.59%(35/962), χ(2)=29.59, P<0.001) were significantly higher in 2013 than those in 2004. Subjects with combined obesity had higher risks of hypertension (OR=5.88, 95% CI: 4.42-7.82), high TG (OR=7.12, 95%CI: 4.35-11.64), low HDL-C (OR=3.04, 95%CI: 1.55-5.95), high LDL-C (OR=2.27, 95% CI: 1.22-4.02), CDs≥2 (OR=3.07, 95% CI: 2.09-4.50), comparing to children without obesity.</p><p><b>CONCLUSION</b>The prevalence of types of obesity and obesity-related metabolic disorders, except for low HDL-C and high HDL-C, were significantly higher in 2013 than those 2004 among chlildren aged 6-17 year in Beijing. Children with combined obesity had higher prevalence of metabolic disorders.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Beijing , Blood Glucose , Blood Pressure , Body Mass Index , Body Weight , Cardiovascular Diseases , Epidemiology , Cholesterol, HDL , Blood , Cholesterol, LDL , Blood , Cross-Sectional Studies , Dyslipidemias , Epidemiology , Hypertension , Epidemiology , Lipids , Blood , Logistic Models , Obesity, Abdominal , Epidemiology , Pediatric Obesity , Epidemiology , Phenotype , Prevalence , Triglycerides , Blood , Waist CircumferenceABSTRACT
BACKGROUND:Reperfusion injury salvage kinase (RISK) pathway plays an important role in protective mechanism against ischemia reperfusion injury (IRI) induced by both ischemic pre-and post-conditioning. Many researches have been carried out on RISK pathway mechanism underlying ischemic post-conditioning conferring cardioprotection against IRI;however, there is less research about its effect on IRI in the skeletal muscle. OBJECTIVE:To investigate the protective effect of an optimized protocol of ischemic post-conditioning on IRI in rat skeletal muscle and its underlying mechanism. METHODS:Eighteen male Sprague-Dawley rats were equivalently randomized into IRI, ischemic post-conditioning and control groups. Rats were given occlusion or disocclusion of the right femoral artery of the right lower limb. Subsequently, the IRI group rats were subjected to 24 hours of reperfusion;the ischemic post-conditioning group immediately given 4 cycles of 30 seconds reperfusion/30 seconds ischemia, followed by 24 hours of reperfusion;the control group given no intervention. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that in the ischemic post-conditioning group, the morphology of muscle fibers changed little, with fewer inflammatory lesions and milder edema compared with the IRI group. The infarct size with TTC staining in the ischemic post-conditioning group was smaller than that in the IRI group. Western blot analysis revealed that the expressions of phospho-Akt and phosphorylated endothelial nitric oxide synthase-S1177 were significantly increased, but the expression of phosphorylated type endothelial nitric oxide synthase-Thr495 was much decreased in the ischemic post-conditioning group compared with the IRI group. The measurement of mitochondrial permeability transition pore opening with Ca2+induction showed that the absorbance values in the ischemic post-conditioning group were significantly lower than those in the IRI group (P<0.05). These results indicate that ischemia-reperfusion injury can be improved by applying an optimal protocol of ischemic post-conditioning in rat skeletal muscle. The underlying mechanism may be associated with the activation of RISK signaling pathway to inhibit opening of mitochondrial permeability transition pore, thereby contributing to the enhanced tolerance to IRI in rat skeletal muscle.